Candice Golembo, Matthew W. Kirkhart, Ph.D., Jen L. Lowry, Ph.D., Jeffrey M. Lating, Ph.D.

Promoting Amputee Life Skills: Outcomes of an Online Interactive Program for Improving Quality of Life Following Limb Loss

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In 2005 in the United States, an estimated 1.6 million individuals were living with the loss of a limb (Ziegler-Graham et al., 2008), with this number being projected to more than double by the year of 2050 to 3.5 million individuals. Limb loss has the potential to be an all-encompassing life altering experience. The impact of limb loss on physical, social, and psychological well-being can be both broad and difficult for many to overcome. Limitations due to bodily function and structure may hinder physical activity levels and participation in everyday activities (Gallagher & MacLachlan, 2000a). Individuals with limb loss may face significant changes to their social roles, intimate relationships, and occupation (Gallagher & MacLachlan, 2000a; Senra et al., 2011), and depression, anxiety, and frustration are often reported by individuals within this population (Akyol et al., 2013; Horgan & Maclachlan 2004; Oliveir & Fragoso, 2006; Senra et al., 2011; Stutts et al., 2015). Thus, limb loss may pose a serious threat to an individual’s psychological health, and overall quality of life. Yet, there appears to be a dearth of mental health outcomes-based research studies regarding the treatment of individuals with limb loss, with the bulk of treatment recommendations never being subjected to empirical review (Yuen, 2017).

There are a number of challenges associated with developing interventions for those with limb loss. The diversity of experiences related to limb loss makes it difficult to collect meta-analytic data on psychosocial outcomes among this population (Sinha & Van Den Heuvel, 2011).

Additionally, this unique population may also face several barriers related to access to care. These barriers can include physical limitations, limited healthcare coverage, excessive medical costs, and decreased feelings of self-efficacy (Associated Press, 2013; Gallagher & MacLachlan, 2000a; Senra et al., 2011; Yuen, 2017).

Therefore, it is imperative that those in the field devise efficacious psychotherapeutic interventions for this population that are ideally home-based and financially feasible. One type of intervention that is both home-based and financially feasible is web-based interventions. Web-based interventions serve as ideal options because they allow for online participation at a financial cost that is not overly burdensome for most. Web-based interventions are increasingly used in various disease settings to enhance patient empowerment (Kuijpers et al., 2013), and most importantly, they appear to be effective in alleviating a variety of mental and physical health difficulties (Kiropoulos et al., 2008; Kuijpers et al., 2013). Additionally, with the advent of COVID-19, clinicians and patients alike have come to realize the full potential and benefit of these digital treatment options (Torous et al., 2020).

The present study aims to address the paucity of research in this area. Promising results from a community-based Promoting Amputee Life Skills (PALS) program prompted the development of a pilot online PALS program. The efficacy of PALS Online, an interactive self-management program that allows participants to work through modules that target common psychological challenges associated with limb loss, will be examined.